5PSQ-108 Comparison of the French prescription guide adapted for the elderly (PAPA guide) with the European STOPP/START (S/S) list

<h3>Background and Importance</h3> 41% of people over the age of 75 suffer from polymedication, resulting in a high iatrogenic risk. Medication-related iatrogenesis is responsible for 20% of emergency hospitalisations among the elderly. Limiting this risk is one of the challenges facing clinical pharmacy. To this end, prescribing aids have been created, such as the PAPA guide, revised in 2015, and the European S/S list of 2023. <h3>Aim and Objectives</h3> Analyse the divergences between the PAPA guide and the S/S list to check their concordance. <h3>Material and Methods</h3> We recorded the prescriptions of patients over 75 years of age, hospitalised in a post-emergency ward. We analysed them using the PAPA guide and the S/S list, in order to identify any divergences in prescribing non-conformities (PNC) between these two guidelines. <h3>Results</h3> After extracting the prescriptions of 50 patients, aged between 75 and 100 years (mean = 86 years), we identified 438 prescription lines. We noted 1,60% PCN divergences (7/438) between these 2 tools. The PAPA guide identifies 5 PCNs that the S/S list does not mention: 3 contraindicated combinations: converting enzyme inhibitor or angiotensin II receptor antagonist in combination with aldosterone antagonist after age 80. 1 contraindication: cognitive risk of biperiden. 1 wrong indication: mirtazapine for insomnia. On the other hand, the S/S list identifies 2 other PCNs compared with the PAPA guide: 1 class duplication: 2 antihistamines simultaneously. 1 risk of adverse effects: systematic use of tramadol. <h3>Conclusion and Relevance</h3> The 2 tools are largely concordant. However, there are various biases: the PAPA guide was last updated in 2015, whereas the S/S list was updated in 2023. Certain drugs are therefore not referenced in the PAPA guide, notably dapagliflozin, tafamidis, and anagrelide. Certain pathologies, such as asthma and allergies, are not listed in the PAPA guide. Finally, unlike the PAPA guide, the S/S list does not take dosage into account. These 2 tools are thus in agreement, but the comparison remains complex due to the different biases and their different formats: digital platform for the S/S list, with detailed arguments for each molecule, versus booklet organised by pathology for the PAPA guide. Their use is therefore complementary. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest